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NPI Code Detail

MEDICARE: NEW HOPE: PHYSICAL SPEECH OCCUPATIONAL AND LMSW SERVICES PLLC

MEDICARE: NEW HOPE: PHYSICAL SPEECH OCCUPATIONAL AND LMSW SERVICES PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1252Y00000XEarly Intervention Provider Agency0111231NY

General Provider Information

NPI Number : 1962795716
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW HOPE: PHYSICAL SPEECH OCCUPATIONAL AND LMSW SERVICES PLLC
Provider Business Mailing Address
First Line : 7 FENWICK ST
Second Line :
City : GREENLAWN
State : NY
Zip : 11740-1405
Country : US
Telephone Number : 631-757-4063
Fax Number : 631-757-4063
Provider Business Practice Location Address
First Line : 27 CATHERINE ST
Second Line :
City : EAST NORTHPORT
State : NY
Zip : 11731-1318
Country : US
Telephone Number : 631-261-9145
Fax Number : 631-262-9145
Authorized Official
Title or Position : SECRETARY/TREASURER MGR MBR
Name : MS. DIANE CEPEDA AMANTIA
Credential : P.T.
Telephone Number : 631-757-4063
Provider Enumeration Date : 05/25/2011
Last Update Date : 05/25/2011

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Directions to “NEW HOPE: PHYSICAL SPEECH OCCUPATIONAL AND LMSW SERVICES PLLC ” Practice Location

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